坏死性筋膜炎中的截肢术——困境还是现实：一例病例报告及文献综述
Amputation in Necrotizing Fasciitis - Dilemma or Reality: A Case Report and Literature Review.
作者信息
Itsiopoulos Iraklis, Vasiliadis Angelo V, Tsitouras Dimosthenis, Goulas Patroklos, Malliou Petroula, Ktenidis Kiriakos
机构信息
Propedeutic Surgical Clinic, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Department of Orthopaedic Surgery, "Papageorgiou" General Hospital of Thessaloniki, Thessaloniki, Greece.
出版信息
J Orthop Case Rep. 2020 Jul;10(4):54-58. doi: 10.13107/jocr.2020.v10.i04.1800.
INTRODUCTION
Necrotizing fasciitis (NF) is known to be a life-threatening condition of the subcutaneous tissue and superficial fascia with rapid progression.
CASE PRESENTATION
This case report will present a relevant case and summarize the literature to discuss the dilemma of amputation in patients with NF. We present the case of a 32-year-old male with a longstanding history of intravenous drug abuse, who developed NF from a benign cellulitis after injection drug use in his right groin region, for which he underwent surgical debridement followed by above-the-knee amputation because of septic shock. He was discharged after 6 months from admission with all blood biochemical parameters recovered to normal.
CONCLUSION
Prompt intravenous antibiotics administration, surgical debridement, fluid and electrolytes management, and analgesia are the pillars of the treatment, while amputation seems to be a life-saving procedure.
引言
坏死性筋膜炎（NF）是一种皮下组织和浅筋膜的危及生命的疾病，进展迅速。
病例报告
本病例报告将呈现一个相关病例并总结文献，以讨论NF患者截肢的困境。我们报告一例32岁男性，有长期静脉药物滥用史，其右腹股沟区注射毒品后由良性蜂窝织炎发展为NF，因感染性休克接受了手术清创及膝上截肢术。入院6个月后出院，所有血液生化指标恢复正常。
结论
及时静脉应用抗生素、手术清创、液体和电解质管理以及镇痛是治疗的支柱，而截肢似乎是一种挽救生命的手术。
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